LATISHA ROSE MUCKER (NPI# 1245733203) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1245733203 |
Entity Type | Individual |
Full Name | LATISHA ROSE MUCKER |
Credential | RECOVERY COACH/PEER |
Practice Address |
1149 N El Dorado St Stockton CA 95202-1305 |
Practice Telephone | 2094682337 |
Practice Fax Number | 2099537400 |
Mailing Telephone | 2094682337 |
Mailing Fax Number | 2099537400 |
Enumeration Date | 2018-03-15 |
Last Update Date | 2018-03-15 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 175T00000X | Peer Specialist | Other Service Providers |
Street Address |
1149 N EL DORADO ST |
City | STOCKTON |
State | CA |
Zip Code | 95202-1305 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710193537 | San Joaquin County Behavioral Health Services | Clinic/Center | 1149 N El Dorado St, Stockton, CA 95202-1305 | 2007-05-16 |
1477012581 | Nayeli Z Cruz | Case Manager/Care Coordinator | 1149 N El Dorado St, Stockton, CA 95202-1305 | 2019-03-18 |
1356821706 | Frances Olivia Quintero | Peer Specialist | 1149 N El Dorado St, Stockton, CA 95202-1305 | 2018-08-15 |
1396283719 | Shazia Niazi | Counselor | 1149 N El Dorado St, Stockton, CA 95202-1305 | 2017-02-06 |
1104375724 | Gloria Cruz | Registered Nurse | 1149 N El Dorado St, Stockton, CA 95202-1305 | 2016-09-23 |
1609324557 | Tatiana Castro | Counselor | 1149 N El Dorado St, Stockton, CA 95202-1305 | 2016-09-20 |
1124474234 | Florencia Rodriguez-tavares | Counselor | 1149 N El Dorado St, Stockton, CA 95202-1305 | 2016-05-06 |
1780039768 | Aries Moses | Non-emergency Medical Transport (VAN) | 1149 N El Dorado St, Stockton, CA 95202-1305 | 2016-04-27 |
1992176341 | Almastro Denny Jr. | Driver | 1149 N El Dorado St, Stockton, CA 95202-1305 | 2015-10-12 |
1942692397 | Celene Munoz | Counselor | 1149 N El Dorado St, Stockton, CA 95202-1305 | 2015-02-23 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336774678 | Lecletus Griffin Jr. | Counselor | 1212 N. Califronia Street, Stockton, CA 95202 | 2020-03-06 |
1861035586 | Andrea Mn Perkins | Social Worker | Sjc Bhs Bacop, 1149 El Dorado Street, Stockton, CA 95202 | 2019-10-25 |
1932664620 | San Joaquin County Behavioral Health Services | Community/Behavioral Health | 1212 N. Califorian St, Stockton, CA 95202 | 2019-02-06 |
1730655895 | Jenaiah La'neise Sauceda | Social Worker | 343 E Main St Ste 918, Stockton, CA 95202 | 2018-10-16 |
1235631722 | Parker Yang | Counselor | 1111 N. El Dorado St, Stockton, CA 95202 | 2018-03-01 |
1912406976 | Janet Mendoza | Social Worker | 6 South Eldorado Street, Stockton, CA 95202 | 2018-02-06 |
1487162087 | Linda Soun | Counselor | 1111 N. El Dorado Street, Stockton, CA 95202 | 2018-01-17 |
1124545355 | Suleyma Velesquez | Counselor | 445 N. San Joaquin St., Stockton, CA 95202 | 2017-08-28 |
1821513946 | Savoeun Phal | Counselor | 1212 N California St Ste A214, Stockton, CA 95202 | 2017-08-09 |
1861921272 | Mandeep K Minhas | Registered Nurse | 1212 California St, Stockton, CA 95202 | 2017-06-08 |
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Taxonomy Code | 175T00000X |
Grouping | Other Service Providers |
Classification | Peer Specialist |
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578103313 | Charles Winfield Eproson Jr. | Peer Specialist | 4545 Georgetown Pl Ste D, Stockton, CA 95207-6229 | 2020-01-09 |
1376086389 | Sabrina Wettstein | Peer Specialist | 1305 E Stadium Dr, Stockton, CA 95204-2426 | 2016-11-22 |
1013462670 | Johnny Chin | Peer Specialist | 2414 Brandywine Ct, Stockton, CA 95210-6752 | 2016-08-23 |
1801292263 | Robert Terrance Williams | Peer Specialist | 1149 North El Dorado, Stockton, CA 95202 | 2014-11-13 |
1831737857 | Gabriela Brizuela | Peer Specialist | 405 E Pine St, Stockton, CA 95204-5522 | 2019-12-20 |
1356821706 | Frances Olivia Quintero | Peer Specialist | 1149 N El Dorado St, Stockton, CA 95202-1305 | 2018-08-15 |
1275089070 | Chia Vang | Peer Specialist | 8338 West Ln Ste 105, Stockton, CA 95210-3145 | 2016-08-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609477629 | Karen J Pompa | Peer Specialist | 2605 E Date Palm Paseo Apt 2194, Ontario, CA 91764-4670 | 2020-11-05 |
1033710231 | Marcus Kujawa | Peer Specialist | 85 Ramona Expy Ste 13, Perris, CA 92571-7014 | 2020-11-04 |
1962001230 | Tanya Geanna Macleod | Peer Specialist | 474 West Vermont Ave., Ste., 101, Escondido, CA 92025 | 2020-10-19 |
1043826753 | Dayjahnay Shantay Davenport | Peer Specialist | 3347 Lincoln Ave, San Diego, CA 92104-2111 | 2020-09-17 |
1497364848 | Marissa Adrianna Garza | Peer Specialist | 1502 Verona Ct, Salinas, CA 93905-2249 | 2020-07-30 |
1235765801 | Jill Nina Bierman | Peer Specialist | 25322 Via Piedra Roja, Laguna Niguel, CA 92677-1824 | 2020-03-16 |
1427683101 | Gerardo Castro | Peer Specialist | 5555 Reservoir Dr # 204-a, San Diego, CA 92120-5134 | 2020-03-03 |
1437783180 | Samuel Guadron Rosales | Peer Specialist | 658 E Brier Dr Ste 250, San Bernardino, CA 92408-2875 | 2020-03-02 |
1356973234 | Salina Sheoli Romero | Peer Specialist | 40 West G Street Ste. B, Los Banos, CA 93635 | 2020-02-07 |
1316585227 | Katelynn Patterson | Peer Specialist | 407 Tate St, Bakersfield, CA 93306-5446 | 2019-12-11 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.